'First in family' experiences in a Canadian medical school: A critically reflexive study.


Journal

Medical education
ISSN: 1365-2923
Titre abrégé: Med Educ
Pays: England
ID NLM: 7605655

Informations de publication

Date de publication:
10 2023
Historique:
revised: 17 03 2023
received: 14 10 2022
accepted: 22 04 2023
medline: 18 9 2023
pubmed: 25 5 2023
entrez: 25 5 2023
Statut: ppublish

Résumé

Medical students from affluent and highly educated backgrounds remain overrepresented in Canadian medical schools despite widespread efforts to improve diversity. Little is known of the medical school experiences of students who are first in their family (FiF) to attend university. Drawing on Bourdieu and a critically reflexive lens, this study explored the experiences of FiF students in a Canadian medical school to better understand the ways in which the medical school environment can be exclusive and inequitable to underrepresented students. We interviewed 17 medical students who self-identified as being FiF to attend university. Utilising theoretical sampling, we also interviewed five students who identified as being from medical families to test our emerging theoretical framework. Participants were asked to discuss what 'first in family' meant to them, their journey into medical school and their experiences at medical school. Bourdieu's theories and concepts were used as sensitising concepts to explore the data. FiF students discussed the implicit messages they received about who belongs in medical school, challenges in shifting from their pre-medical lives to a medical identity and competing with peers for residency programmes. They reflected on the advantages they perceived they had over their fellow students due to their less 'typical' social backgrounds. While medical schools continue to make strides when it comes to increasing diversity, inclusivity and equity require increased attention. Our findings highlight the ongoing need for structural and cultural change at admissions and beyond-change that recognises the much-needed presence and perspectives that underrepresented medical students, including those who are FiF, bring to medical education and healthcare. Engaging in critical reflexivity represents a key way that medical schools can continue to address issues of equity, diversity and inclusion.

Sections du résumé

BACKGROUND
Medical students from affluent and highly educated backgrounds remain overrepresented in Canadian medical schools despite widespread efforts to improve diversity. Little is known of the medical school experiences of students who are first in their family (FiF) to attend university. Drawing on Bourdieu and a critically reflexive lens, this study explored the experiences of FiF students in a Canadian medical school to better understand the ways in which the medical school environment can be exclusive and inequitable to underrepresented students.
METHODS
We interviewed 17 medical students who self-identified as being FiF to attend university. Utilising theoretical sampling, we also interviewed five students who identified as being from medical families to test our emerging theoretical framework. Participants were asked to discuss what 'first in family' meant to them, their journey into medical school and their experiences at medical school. Bourdieu's theories and concepts were used as sensitising concepts to explore the data.
RESULTS
FiF students discussed the implicit messages they received about who belongs in medical school, challenges in shifting from their pre-medical lives to a medical identity and competing with peers for residency programmes. They reflected on the advantages they perceived they had over their fellow students due to their less 'typical' social backgrounds.
CONCLUSION
While medical schools continue to make strides when it comes to increasing diversity, inclusivity and equity require increased attention. Our findings highlight the ongoing need for structural and cultural change at admissions and beyond-change that recognises the much-needed presence and perspectives that underrepresented medical students, including those who are FiF, bring to medical education and healthcare. Engaging in critical reflexivity represents a key way that medical schools can continue to address issues of equity, diversity and inclusion.

Identifiants

pubmed: 37226410
doi: 10.1111/medu.15116
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

980-990

Subventions

Organisme : Education Development Fund, Temerty Faculty of Medicine and the Department of Family and Community Medicine, University of Toronto

Informations de copyright

© 2023 The Authors. Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.

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Auteurs

Sarah R Wright (SR)

Toronto East Health Network, Michael Garron Hospital, Toronto, Ontario, Canada.
The Wilson Centre, The University Health Network, Toronto, Ontario, Canada.
The Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Victoria A Boyd (VA)

The Wilson Centre, The University Health Network, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Ike Okafor (I)

Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Malika Sharma (M)

St. Michael's Hospital, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Ryan Giroux (R)

Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
St. Michael's Hospital, Toronto, Ontario, Canada.

Lisa Richardson (L)

Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Centre for Wise Practices in Indigenous Health, Women's College Hospital, Toronto, Ontario, Canada.

Caragh Brosnan (C)

School of Humanities, Creative Industries & Social Sciences, College of Human and Social Futures, University of Newcastle, Callaghan, Australia.

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